Capsulotomy in hip arthroscopy has been used since the 1990's for better exposure and mobility of instruments, as popularized by James M. Glick. As the arthroscopic hip procedures have become more extensive requiring better access to both the central and peripheral compartments for removal of metaplastic bone as in treating Femoroacetabular Impingement, capsulotomy similar to open techniques has been employed.
An arthroscopic capsular incision is made along the neck of the femur and extended over the labrum taking it along the acetabular rim to expose an area from the base of the femoral neck to the supra acetabular Ilium with an RF probe. It is considered extensive relative to the minimally invasive hip arthroscopic technique. Addition comments on the use of capsulotomy for loose body removal and reshaping of the head neck junction and acetabular rim as well as labral refixation and reconstruction will be discussed.
Since 1999 more than 1000 consecutive hip arthroscopies have been performed by this single surgeon using the technique. The indications and techniques will be discussed as well as the lack of complications. Capsular repair is done when indicated for concerns of instability and rapid return to activities.
Extensive capsulotomy for ideal exposure and treatment in hip arthroscopy is safe and effective. Better exposure and access to central and peripheral spaces are obtained over conventional portal techniques. Complications such as fluid extravasation and dislocation are rare.
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